Rodriguez-Gallego E, et al. - The ability of the lipoprotein profile to predict dyslipidemia onset in HIV patients undergoing antiretroviral therapy (ART) was assessed using nuclear magnetic resonance (NMR) spectroscopy. Relative to biochemical markers associated with conventional lipid measurements, HIV/ART-related dyslipidemia onset was better predicted by circulating metabolites. Changes in VLDL-P, lactate and LDL-TG were identified, using NMR, as potential clinical markers of baseline HIV-dyslipidemia predisposition. Important derangements of mitochondrial function that are linked to ART-related dyslipidemia were indicated by differences in circulating metabolomics, especially differences in particle size.

Methods

• Researchers used a circulating metabolomic approach in a cohort of 103 ART-naive HIV-infected patients, who were initiating non-nucleoside analogue transcriptase inhibitor (NNRTI)-based ART.
• They followed these patients for 36 months.
• They carried out univariate and multivariate analyses to assess the predictive power of NMR spectroscopy.

Results

• Researchers found VLDL-metabolism (including VLDL lipid concentrations, sizes, and particle numbers), total triglycerides and lactate levels resulted in good classifiers of dyslipidemia (AUC 0.903).
• Total particles/HDL-P ratio was shown to be significantly higher in ART-associated dyslipidemia vs ART-normolipidemia (p=0.001).
• Positive association of large VLDL-Ps with both LDL-triglycerides (ρ 0.682, p <0.001) and lactate concentrations (ρ 0.416, p <0.001) was noted, the last one being a marker of mitochondrial low oxidative capacity.